Exploring the intersection between safety culture and hospital nursing practice

探索安全文化与医院护理实践之间的交叉点

• 批准号: 7865417
• 负责人: Patricia Groves
• 金额: $ 3.78万
• 依托单位: UNIVERSITY OF MISSOURI-COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-03-01 至 2011-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7865417
• 关键词: Exploring; intersection; between; safety; culture

DESCRIPTION (provided by applicant): The purpose of this grounded theory study is to examine how organizational context (communicated structures of rules and resources) constrain and enable individual hospital staff nurses' ability to keep patients safe. Patient safety is a significant problem with extensive human and healthcare costs. To date, the interaction between organizational structures and the actions of individual nurses to keep patients safe has been neglected in safety culture research. Thus, consistent with AHRQ's mission to improve the quality, safety, efficiency, and effectiveness of healthcare, the specific aim of this study is to describe the process by which hospital staff nurses (agents) keep patients safe, while constrained/enabled by sets of safety rules and resources (safety culture structures) in the organization. This study is framed using Structuration Theory; a cross-sectional, qualitative design will be used. Consistent with grounded theory methodology, data collection, analysis, and sampling will be simultaneous and reciprocal, allowing for grounding in the data through constant comparative analysis and theoretical sampling. Semi-structured interviews will be conducted with an initial sample of ten hospital staff nurses at a Midwest academic medical center. These interviews will be used to elicit narratives about patient safety experiences. Simultaneous with data collection efforts, incoming data will be analyzed using grounded theory methods. Sampling beyond the initial participants will be theoretical and based on emerging data categories and identification of gaps in the emergent theory. When theoretical saturation is reached, the categories will be integrated into a substantive grounded theory of the process used by nurses to keep patients safe within the safety culture of an organization. Long-term benefits from this study include advancement of knowledge about how safety culture influences nursing practice, which in turn will allow tailored modifications of safety cultures to promote increased safety for patients.

描述（由申请人提供）：这项扎根理论研究的目的是检查组织环境（规则和资源的沟通结构）如何限制和增强医院护士个人保障患者安全的能力。患者安全是一个重大问题，造成巨大的人力和医疗成本。迄今为止，在安全文化研究中，组织结构与护士个人为保证患者安全而采取的行动之间的相互作用一直被忽视。因此，与 AHRQ 提高医疗保健质量、安全性、效率和有效性的使命相一致，本研究的具体目的是描述医院护士（代理人）在受到一系列约束/支持的情况下保证患者安全的过程。组织中的安全规则和资源（安全文化结构）。这项研究是使用结构理论构建的；将使用横截面定性设计。与扎根理论方法一致，数据收集、分析和抽样将是同时且相互的，允许通过不断的比较分析和理论抽样来扎根数据。半结构化访谈将对中西部学术医疗中心的 10 名医院护士进行初步抽样。这些访谈将用于引出有关患者安全经历的叙述。在数据收集工作的同时，将使用扎根理论方法对传入数据进行分析。除了初始参与者之外的抽样将是理论上的，并且基于新兴数据类别和对新兴理论中差距的识别。当理论达到饱和时，这些类别将被整合到护士使用的流程的实质性基础理论中，以在组织的安全文化中保证患者的安全。这项研究的长期好处包括提高有关安全文化如何影响护理实践的知识，这反过来又允许对安全文化进行量身定制的修改，以提高患者的安全性。